172 Where There Is No Doctor 2011
HEPATITIS
Hepatitis is an inflammation of the liver usually caused by a virus, but also by
bacteria, alcohol, or chemical poisoning. There are 3 major types of hepatitis (A, B,
and C) and it can spread from person to person whether or not there are signs of the
disease. Even though in some places people call it ‘the fever’ (see p. 26), hepatitis
often causes little or no rise in temperature.
A person with Hepatitis A or Hepatitis B is often very sick for 2 to 3 weeks, weak for
1 to 4 months after, and then usually gets better.
Hepatitis A is usually mild in small children, but more serious in older persons and in
pregnant women. Hepatitis B is more serious and can lead to permanent scarring of the
liver (cirrhosis), liver cancer, and even death. Hepatitis C is also very dangerous and can
lead to permanent liver infections. It is a major cause of death for people with HIV.
Signs:
• Feels tired. Does not want to
eat or smoke. Often goes days
without eating anything.
• Sometimes there is a pain on
the right side near the liver.
Sometimes there is pain in
the muscles or joints.
Treatment:
• May have a fever.
• After a few days, the eyes
and skin turn yellow.
• Sight or smell of food
may cause vomiting.
• The urine may turn dark like
Coca Cola, and the stools
may become whitish, or the
person may have diarrhea.
♦ Antibiotics do not work against hepatitis. In fact some medicines such as
acetaminophen will cause added damage to the sick liver. Do not use medicines.
♦ The sick person should rest and drink lots of liquids. If he refuses most food, give
him orange juice, papaya, and other fruit plus broth or vegetable soup. It may help
to take vitamins. To control vomiting, see p. 161.
♦ When the sick person can eat, give a balanced meal. Vegetables and fruit are
good, with some protein (p. 110 to 111). But do not give a lot of protein (meat,
eggs, fish, etc.) because this makes the damaged liver work too hard. Avoid lard
and fatty foods. Do not drink any alcohol for at least 6 months.
Prevention:
♦ Small children often have hepatitis without any signs of sickness, but they can
spread the disease to others. It is very important that everyone in the house follow
all the guidelines of cleanlines with great care (see pages 133 to 139).
♦ The Hepatitis A virus passes from the stool of one person to the mouth of another
by way of contaminated water or food. To prevent others from getting sick, bury
the sick person’s stools. The sick person, his family and caregivers must try to stay
clean and wash their hands often.
♦ The Hepatitis B and Hepatitis C viruses can pass from person to person through
sex, injections with unsterile needles, transfusions of infected blood and from
mother to baby at birth. Take steps to prevent passing hepatitis to others: use a
condom during sex (see p. 290), follow the HIV prevention suggestions on p. 401,
and always boil needles and syringes before each use (see p. 74).
♦ Vaccines now exist for Hepatitis A and Hepatitis B but they may be expensive or
not be available everywhere. Hepatitis B is dangerous and there is no cure, so if the
vaccine is accessible all children should be vaccinated.
WARNING: Hepatitis can also be transmitted by giving injections with unsterile needles:
Always boil needles and syringes before each use (see p. 74).